Final Scholarly Project: The Administration of Transversus Abdominis Plane Blocks in Patients Undergoing Anesthesia for Open Ventral Hernia Repairs

Ventral hernia repairs are the only definitive treatment for umbilical or abdominal hernias. These procedures are prevalent and often lifesaving but also carry high risks of adverse effects. Some of the problems that follow include postoperative ileus, increased opioid use, and prolonged length of stay. Due to the rate of complications, there was a need to improve these outcomes. One way to improve outcomes is to implement superior anesthetic techniques. This Final Scholarly Project (FSP) followed the Plan-Do-Study-Act (PDSA) model to conduct evidence-based practice (EBP) and quality improvement (QI) sections. The plan phase included a thorough literature search and analysis and the design of recommendations. Current literature shows that the administration of transversus abdominis plane (TAP) blocks in patients undergoing open ventral hernia repairs decreases total opioid use and reduces length of hospital stay. The recommendation includes an ultrasound-guided technique to administer a TAP block in the operating room before incision. The TAP block will consist of liposomal bupivacaine and normal saline. There will be 60 milliliters of the anesthetic administered bilaterally. The Do phase includes the proposed implementation of the recommendations, which include training and communication with stakeholders. The Study phase will include collection of data and analysis of outcomes. The measured outcomes will be total opioid use and length of hospital stay. The Act phase will include adjusting the recommendation as necessary to achieve the best possible patient outcomes. The goal of the project is to improve outcomes for patients undergoing ventral hernia surgery by implementing EBP strategies.